Application Form for Integrative Health Coach Training

Application instructions for CERTIFIED INTEGRATIVE MENTAL HEALTH COACH TRAINING PROGRAM

Before you apply, please downloaded our INFORMATION KIT
Any information you share via this website is private. For more information, please read our full privacy policy.

If your application is approved, you will be emailed a consent form and a payment link.

We now offer 2 and 4 month payment plan options. Each monthly installment includes a $50 finance fee.
All payments are in US dollars. Please note that Canadian residents are required to pay their provincial tax rate.

Legal NameStreet Address CityState/Province, Zip/Postal CodePhone Number (where you prefer to be contacted, if needed)Email AddressBirthdate Education (please include your field of study)Previous Experience (list only those roles that are relevant to your participating in the Integrative Health Coach Training Program)Medical Conditions (optional)Tell us about your interest in mind-body-spirit health and wellness. What life events transpired to bring you here?How would you like to apply your health coach training in your professional life? (working in a health organization, private practice, supplement your current position)Are you currently working? If so, in what profession?How do you best like to learn? (Visual, auditory, reading? Group discussions or individual?)How did you hear about this course?Were you referred to our program?If approved, what date do you intend to start the course?Today's Date

By submitting this application, I confirm that the information given in this form is complete and accurate.

Thank you! Your submission has been received! You will be contacted with 48 hours.

Oops! Something went wrong while submitting the form. Please try again or email us at : training@nickersoninstitute.com

Application Form

for the Integrative Mental Health Coach Training Program‍‍

Application instructions for CERTIFIED INTEGRATIVE MENTAL HEALTH COACH TRAINING PROGRAM

If your application is approved, you will be emailed a consent form and a payment link.

for the Integrative Mental Health Coach Training Program
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